Wednesday, October 26, 2016

What To Know About the ‘Flesh-Eating Bacteria’ That Killed a Man in Maryland

Headlines this week about a man who died after contracting a “flesh-eating bacteria” in Ocean City, Maryland, may have you spooked to go near the water, or even near seafood. Michael Funk, 67, began to feel ill within hours of cleaning out crab pots at his beach home, and died just four days later.

Doctors say that a cut on Funk’s leg was exposed to a strand of Vibrio bacteria called Vibrio vulnificus, which lives in warm, coastal waters like Ocean City’s Assawoman Bay. He was diagnosed at the hospital with the infection caused by Vibrio, called vibriosis, and had infected skin removed from around the wound. But the bacteria had already entered his bloodstream. Despite having his leg amputated, Funk did not survive.

His wife told local newspaper The Daily Times that the experience was “like something out of a horror movie,” expressing concern that there had been no warning from Ocean City officials about the bacteria or their risks. (The Maryland Department of Health and Mental Hygiene is investigating the incident. A public advisory has not been issued, although information about Vibrio can be found on the official state website.)

While tourist season on the Maryland coast is over, there are still plenty of places in the United States where people swim, boat, and catch seafood year-round. So Health spoke with Gabby Barbarite, PhD, a Vibrio researcher at Florida Atlantic University’s Harbor Branch Oceanographic Institution, to find out how much of a risk these bacteria pose to the average person. Here’s what you should know, and how to keep yourself safe.

Vibrio bacteria aren’t new

There are about 12 Vibrio species that make people sick, and they've been around for many years. This is likely not the first time you’ve read about them in the news, either. In Florida, at least two people died last year (and at least seven died in 2014) as a result of vibriosis.

According to the Centers for Disease Control and Prevention,vibriosis causes an estimated 100 deaths in the U.S. each year. It also causes an estimated 80,000 illnesses—52,000 of which are from eating contaminated seafood like raw oysters.

Vibrio bacteria live in coastal bodies of salt water or brackish water. They’re found year-round in warm climates like Florida; further north, their levels peak in late summer and early fall, when water is warmest.

“People often ask why we don’t just get rid of the bacteria,” says Barbarite, “but in reality, we’re never going to get rid of it all. What we can do is teach people how to stay safe—how they can safely handle seafood and safely spend time in the water.”

In most cases, it’s not as scary as it sounds

Vibrio has been dubbed a type of flesh-eating bacteria, thanks to the blistering skin lesions that can spread quickly across the body if an infection isn’t treated. But Barbarite says that term isn’t quite right.

“The words flesh-eating might make you think that if you touch it, it will degrade your skin on contact, and that’s not true,” she says. “You have to have a pre-existing cut—or you have to eat raw, contaminated seafood or chug a whole lot of contaminated water—for it to get into your bloodstream; it can’t break down healthy, intact skin.”

Men over 50 are at higher risk

Almost every case of serious illness or fatality fromvibriosis occurs in men over 50, says Barbarite, and most are people with compromised immune systems because of a condition like liver disease, heart disease, or diabetes. (Healthy immune systems are usually able to fight off infections before they become life-threatening. News reports have not identified whether Funk had any pre-existing health conditions.)

“Studies have shown that estrogen can actually combat infections, so that’s why we see it more in males than in females,” says Barbarite. Men also tend to have higher levels of iron, she adds, which the bacteria need to thrive.

Contact with contaminated fish and shellfish is also a risk factor, and crabs are known to carry Vibrio bacteria on their shells. “If that bacteria gets into a cut, it can get into your bloodstream and progress very rapidly,” says Barbarite. “Within 12 hours it could be fatal.”

Prompt attention is vital

Healthy people don’t need to avoid the water or stay away from seafood, says Barbarite. Still, it’s important to keep open wounds away from seawater and raw seafood. If you do get cut in or around a marine environment, wash the area thoroughly, and as soon as possible, with soap and clean water.

“People need to know that if they get cut, to clean it out right away and to seek medical attention within four to five hours if they see redness or swelling,” says Barbarite. Fever and nausea are also red flags that the vibriosis infection has spread to the bloodstream. If caught early enough, treatment with antibiotics can be life-saving.

Climate change may mean more infections

In August, a study published in the Proceedings of the National Academy of Sciences suggested that warmer ocean temperatures may be fueling the growth of dangerous bacteria—including Vibrio—in northern seas. This could explain an increase in the number of people in Europe (where the study was conducted) getting sick from swimming or eating tainted seafood, say the study authors, and it could make infections more likely in other warm climates as well.